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Disclaimer: By clicking the (Submit Message) button above you here by agree to the following:

I certify that the information I am submitting is 100% factual to the best of my knowledge.

I understand that all information submitted is confidential and will not be shared with outside sources.

I understand that I may not be contacted back immediately and that response times are dependent upon operation hours. This is not a 24/7 response line, any emergency should be handled by contacting us at (918) 567-7000 extension 0, 911, or a local emergency number.

I understand that if the information I have provided is not coherent or there is insufficient information to contact you, you will NOT be contacted.

I understand that any attempts to commit fraud or any other dishonest act will be met with disciplinary and or legal action for you and any party involved in this endeavor.

I understand that when I submit this information my computerís information will be recorded and submitted along with my message. This information is solely for the purpose of logging records to help prevent misuse of the system.

I understand that if I have any questions about my medications that I should contact a attending pharmacist immediately before you take any medications. If there is not one available, please contact the CNHSA Emergency Room at (918) 567-7000 extension 0. If there is an emergency I should contact 911, or another local emergency number.

I understand that the Choctaw Nation Health Services Authority will not be held liable for any misuse of this refill request system or any other part of the CNHSA website.